An Act relating to Kansas insurance coverage for children;
concerning the six month waiting

period; amending K.S.A. 38-2001 and repealing the existing
section.

Be it enacted by the Legislature of the State of Kansas:

Section 1. K.S.A. 38-2001 is hereby
amended to read as follows: 38-
2001. (a) The secretary of social and rehabilitation services shall
develop
and submit a plan consistent with federal guidelines established
under
section 4901 of public law 105-33 (42 U.S.C. 1397aa et seq.;
title XXI).

(b) The plan developed under subsection
(a) shall be a capitated man-
aged care plan covering Kansas children from zero to 19 years
which:

(1) Contains benefit levels at least
equal to those for the early and
periodic screening, diagnosis and treatment program;

(2) provides for presumptive eligibility
for children where applicable;

(3) provides continuous eligibility for
12 months once a formal de-
termination is made that a child is eligible subject to subsection
(e);

(4) has performance based contracting
with measurable outcomes in-
dicating age appropriate utilization of plan services to include,
but not
limited to, such measurable services as immunizations, vision,
hearing and
dental exams, emergency room utilization, annual physical exams
and
asthma;

(5) shall use the same prior
authorization standards and requirements
as used for health care services under medicaid to further the goal
of
seamlessness of coverage between the two programs; and

(c) The secretary is authorized to
contract with entities authorized to
transact health insurance business in this state to implement the
health
insurance coverage plan pursuant to subsection (a) providing for
several
plan options to enrollees which are coordinated with federal and
state
child health care programs, except that when contracting to provide
man-
aged mental health care services the secretary shall assure that
contracted
entities demonstrate the ability to provide a full array of mental
health
services in accordance with the early and periodic screening,
diagnosis
and treatment plan. The secretary shall not develop a request for
proposal
process which excludes community mental health centers from the
op-
portunity to bid for managed mental health care services.

(d) When developing and implementing the
plan in subsection (a),
the secretary to the extent authorized by law:

(1) Shall include provisions that
encourage contracting insurers to
utilize and coordinate with existing community health care
institutions
and providers;

(2) may work with public health care
providers and other community
resources to provide educational programs promoting healthy
lifestyles
and appropriate use of the plan's health services;

(3) shall plan for outreach and maximum
enrollment of eligible chil-
dren through cooperation with local health departments, schools,
child
care facilities and other community institutions and providers;

(4) shall provide for a simplified
enrollment plan;

(5) shall provide cost sharing as allowed
by law;

(6) shall not count the caring program
for children, the Kansas health
insurance association plan or any charity health care plan as
insurance
under subsection (e)(1); and

(7) may provide for payment of health
insurance premiums, including
contributions to a medical savings account if applicable, if it is
determined
cost effective, taking into account the number of children to be
served
and the benefits to be provided.

(e) A child shall not be eligible for
coverage and shall lose coverage
under the plan developed under subsection (a) of K.S.A. 38-2001,
and
amendments thereto, if:

(1) During the prior six months,
the child was covered with a com-prehensive health insurance policy by an insurance company,
healthmaintenance organization or nonprofit hospital and medical
insurancecorporation authorized to do business in this state and
such insurance isstill available to the child; or

(2) such child's
family has not paid the enrollee's applicable share of
any premium due.

If the family pays all of the delinquent
premiums owed during the year,
such child will again be eligible for coverage for the remaining
months
of the continuous eligibility period.

(f) The plan developed under section 4901
of public law 105-33 (42
U.S.C. 1397aa et seq., and amendments thereto) is not an
entitlement
program. The availability of the plan benefits shall be subject to
funds
appropriated. The secretary shall not utilize waiting lists, but
shall monitor
costs of the program and make necessary adjustments to stay within
the
program's appropriations.

Sec. 2. K.S.A. 38-2001 is hereby repealed.
Sec. 3. This act shall take effect and be in force
from and after its
publication in the Kansas register.

Approved March 30, 2001.
Published in the Kansas Register April 5, 2001.